Alcoholism Case

Guidance for practice The guidance we give here will be very helpful for you if you can manage to get a partner. (Not necessarily a medical student, any friend will do, i.e. your wife/ husband). • You need to ask your partner (SP) to read his/her notes first. It is even easier if he can mark all the positive things. • Time your practice session. This is very important. Most important to remember is that your time starts before you enter the room. You have 15min starting outside the room. • After the session is completed (i.e. within 15 minutes) you go and see the checklist for that case. If you do more than 65% usually you will pass in the exam. But, we advise you try to make at least 75% during the practice session. In the exam obviously you will miss many things more easily because of tension. So, don't worry if you miss in the practice session but not in the exam. The only way to overcome this problem is practice, practice and practice ... We advise everyone to practice these cases at least 3 times in a timed manner. • Please do not skip any part, as you need to time everything for each case. Abbreviations Note: This list is intended to cover the most of the abbreviations widely used in the hospitals of USA. A Abd Abdomen ACEIs Angiotensin Converting Enzyme Inhibitors ACTH Adrenocorticotropic Hormone ADH Antidiuretic Hormone AF Atrial Fibrillation AFB Acid Fast Bacilli AIDS Acquired Immune Deficiency syndrome AML Acute myeloid leukemia ALL Acute Lymphoblastic leukemia ALS Amyotrophic lateral sclerosis Acute MI Acute Myocardial Infarction ANA Anti nuclear antibody ANCA Antineutrophil cytoplasm antibody Anti SMA Anti smooth muscle antibody AP Anterioposterior aPTT Activated Partial Thromboplastin Time AR Aortic Regurgitation AS Aortic stenosis ARDS Acute Respiratory Distress syndrome ARF Acute renal failure ASLOtiter Anti streptolysin O titers ATN Acute tubular necrosis B BCG Bacillus Calmette Guerin bid/tid two times a day/three times a day BMP Basic metabolic profile BS Breath sounds/Bowel sounds BUN Blood urea nitrogen C Ca. Carcinoma Ca +2 Calcium CABG Coronary Artery Bypass Grafting CAD Coronary artery disease CBC Complete Blood Count CBD Common bile duct cc cubic centimeter CEA Carcinembryonic antigen CHF Congestive heart failure CCF Congestive cardiac failure CK Creatine kinase CK MB Creatine kinase myocardial band cm centimeter CML Chronic myelogenous leukemia CMV Cytomegalovirus CNS Central nervous system c/o complaining of COPD Chronic obstructive lung disease CPAP Continuous positive airway pressure CPK Creatine phosphokinase CPR Cardiopulmonary resuscitation Cr Creatine C/S Culture and sensitivity CSF Cerebrospinal fluid C-sec Cesarean section CT scan Computed tomography CVA Cerebrovascular accident CVA tenderness Costovertebral angle tenderness CXR Chest X ray D D&C Dilation and Curettage DIC Disseminated Intravascular Coagulation DKA Diabetic Ketoacidosis DM Diabetes Mellitus DPT Diptheria Pertussis Tetanus DTs Delirium Tremens DUB Dysfunctional Uterine Bleeding DVT Deep Venous Thrombosis D5W Dextrose 5% in water Dx Diagnosis E EBV Epstein Barr Virus ECG/ EKG Electrocardiogram ED/ER Emergency Department/Emergency Room EEG Electroencephalogram ENT Ear Nose Throat EGD Esophago gastro duodenoscopy EIA Enzyme immunoassay ELISA Enzyme linked immunoassay EMG Electromyography EOMI Extraocular movements Intact EPS Extrapyramidal symptoms ERCP Endoscopic retrograde cholangiopancreatography ESR Erythrocyte Sedimentation rate ETOH Ethanol Ext. Extremities F F female FDPs Fibrin degradation products Fe Iron FFP Fresh frozen plasma FH Family History FHR Fetal Heart Rate FNAC Fine needle aspiration cytology FSH Follicle stimulating hormone FTA ABS Flourescent treponemal antibody absorbed 5-FU 5 fluorocil FUO Fever of undetermined origin Fx. Fracture G gm gram GB Gall Bladder GERD Gastroesophageal reflux disease GFR Glomerular filtration rate GGT Gamma glutamyl transferase GI Gastrointestinal tract AGN Acute Glomerulonephritis G6PD Glucose 6 phosphate dehydrogenase GTT Glucose Tolerance test GU Genitourinary GVHD Graft versus Host disease Gyn. Gynecology H H2 Histamine –2 Hep.A Hepatitis A Virus Hb Hemoglobin HBcAg Hepatitis B core Antigen HbsAg Hepatitis B surface Antigen HBIG Hepatitis B immunoglobulin HBV Hepatitis B virus Hco3 Bicarbonate Hct Hematocrit HCV Hepatitis C virus HDL High density lipoprotein HEENT Head, eye, ear, nose, throat hCG Human Chorionic gonadotropin HIV Human immunodeficiency virus H/O history of HPI History of presenting illness hr Hour HR Heart rate HSV Herpes simplex virus HTN Hypertension Hx. History I IBD Inflammatory bowel disease IBS Irritable bowel syndrome IHD Ischaemic heart disease IDDM Insulin dependent diabetes mellitus Ig Immunoglobulin IM Intramuscular Inj Injection INR International normalized ratio IQ Intelligent quotient IUD Intrauterine device IV Intravenous J JVD Juglar venous distension JVP Juglar venous pulse K Kg Kilogram KUB Kidney ureter bladder L Lt Left LAD Left axis deviation LAHB Left anterior hemi block Lb Pound LBBB Left bundle branch block LDH Lactate dehydrogenase LDL Low density lipoprotein LES Lower esophageal sphincter LFTs Liver function tests LGV Lymphogranuloma venereum LH Luteinizing Hormone LLQ Left lower quadrant LMP Last menstrual period LP Lumbar puncture LPHB Left posterior hemiblock LSB Left sternal border LUQ Left upper quadrant LVH Left ventricular hypertrophy M M Male MAC Mycobacterium avium complex MCP Metacarpophalangeal MCV Mean corpuscular volume MVP Mitral Valve prolapse MS Mitral stenosis MR Mitral regurgitation MDS Myelo Dysplastic syndromes MRSA Methicillin Resistant Staphylococcus aureus MSSA Methicillin Sensitive Staphylococcus aureus MVA/RTA Motor vehicle accident/ Road Traffic Accident N NA Not applicable NaHCO3 Sodium Bicarbonate Neuro Neurologic NIDDM Non Insulin dependent diabetes mellitus NG Nasogastric NKA No known allergies NKDA No known drug allergies NL Normal limits NPH Normal pressure hydrcephalus NPH Neutral Protamine Hagedorn (insulin) NPO Nothing by mouth NS Normal saline NT Non tender (Abdomen) ND Non Distended NSR Normal sinus rhythm NSAIDs Nonsteroidal anti-inflammatory drugs O Obg & Gyn Obstetrics & Gynecology Ophth. Ophthalmology OR Operating room Ortho. Orthopedics oz ounce P PR Pulse Rate P2 Pulmonic second sound PA Posterior anterior Pap smear Papanicolaou smear para Number of pregnancies PCP Pneumocystitis carnii pneumonia PCR Polymerase chain reaction PCWP Pulmonary capillary wedge pressure PE Physical examination/Pulmonary embolism ped pediatric Pupils equal, round and reactive to light and PERRLA accommodation PFTs Pulmonary Function tests PMH Past medical history HPI History of Present Illness PID Pelvic inflammatory disease PIP joints Proximal interphalangeal joint PKU Phenylketonuria PMI Point of maximal impulse PMR Polymyalgia rheumatica PND Paroxysmal nocturnal dyspnea PO By mouth PPD test Purified protein derivative PPD Packs Per Day (Sigarettes) PROM Premature rapture of membrane prn As needed PSA prostate specific antigen PSGN Poststreptococcal glomerulonephritis PSVT Paroxysmal Supraventricular tachycardia Psych Psychiatry Pt. patient PT Prothrombin time PTT Partial prothrombin time PTC Percutaneous transhepatic cholangiography PTCA Percutaneous transluminal coronary angioplasty Path Pathology PTH Parathormone PUD Peptic ulcer disease PVC Premature ventricular contraction Q q Every qd Everyday qid Four times daily R Rt. Right R.R Respiratory Rate RBBB Right Bundle Branch Block RBC Red Blood Cell REM sleep Rapid eye movement sleep Rh Rhesus factor RLQ Right lower quadrant ROM Range of motion ROS Review of systems RPGN Rapidly progressive glomerulonephritis RPR Rapid Plasma reagin rt-PA Recombinant tissue plasminogen activator RTA Renal Tubular acidosis RUQ Right upper quadrant RVH Right ventricular hypertrophy S S Soft (Abdomen) S1 First Heart sound S2 Second Heart sound S3 Third Heart sound S4 Fourth Heart sound SA Sinoatrial SAH Subarachnoid hemorrhage SABE Subacute bacterial endocarditis SQ Subcutaneous SGA Small for gestational age SGOT Serum glutamic oxaloacetic transaminase SH Social History Syndrome pf inappropriate secretion of antidiuretic SIADH hormone SGPT Serum glutamic pyruvate transaminase SL Sublingual SLE Systemic lupus erythematosus SLR Straight leg raising test SOB Shortness of breath Stat immediately STD Sexually transmitted disease Surg. Surgery SVT Supraventricular tachycardia T Temp. Temperature T3 Triiodothyronine T4 Thyroxine Tab. Tablet TAH Total abdominal hysterectomy TB Tuberculosis TIA Transient ischemic attack TIBC Total Iron binding Capacity TSH Thyroid stimulating hormone Tx Therapy U U/A Urinanalysis Upper GI Upper Gastrointestinal Tract USG Ultrasonogram URI Upper Respiratory Tract Infection UTI Urinary Tract Infection UV Ultraviolet V VDRL Venereal disease research laboratories VF Ventricular fibrillation VLDL Very low-density lipoprotein W WM White Male WF White Female WBC White blood cell WNL Within normal limits WPW syndroem Wolff Parkinson White syndrome Wt. Weight X x Times Z ZDV Zidovudine General History The most difficult part of the exam is time maintenance. The examination must be completed in 15 minutes. You must make the optimum use of your time. Introduction and greeting: "Hello Mr. Xyz. Good morning or Good afternoon. I am Dr. xyz. It’s nice to meet you (shake hand). Next ask: "What brings you to see me today?" or "What brings you in today?" SP will tell you the chief complaint (cc). Then ask one open- ended question: "Could you please describe to me exactly

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